Evaluating an Intervention to Promote Access to Mental Healthcare for Low lLanguage Proficient Migrants and Refugees across Europe (MentalHealth4All): A Study Protocol

Background
Migrants and refugees with low language proficiency (LLP) have a higher risk of experiencing certain mental health disorders compared to non-migrant populations. They are also more likely to experience a lack of access to mental healthcare due to language- and culture-related barriers. As part of the MentalHealth4All project, a digital multilingual communication and information platform was developed to promote access to mental healthcare for LLP migrants and refugees across Europe. This paper describes the study protocol for evaluating the platform in practice, among both health and/or social care providers (HSCPs) and LLP migrants and refugees.
Methods
We will conduct a pretest-posttest cross-national survey study to perform the platform’s effect-evaluation (primary objective) and process-evaluation (secondary objective). The primary outcomes (measured at T0, T2 and T3) are four dimensions of access: availability, approachability, acceptability, and appropriateness of mental healthcare. Secondary outcomes (measured at T2) are: actual usage of the platform (i.e. tracking data), ease of use, usefulness of content, comprehensibility of information, attractiveness of content, and emotional support. Participants will be recruited from nine European countries: Belgium, Germany, Italy, Lithuania, the Netherlands, Poland, Slovakia, Spain, and the United Kingdom. Using convenience sampling through professional networks/organisations and key figures, we aim to include at least 52 HSCPs (i.e. 6-10 per country), and 260 LLP migrants (i.e. 30-35 per country). After completing a pretest questionnaire (T0), participants will be requested to use the platform and HSCPs will participate in an additional personalised training (T1). Next, participants will fill out a posttest questionnaire (T2), and will be requested to participate in a second posttest questionnaire (T3, about 6-8 weeks after T2) to answer additional questions on their experiences through a brief phone interview (T3 is optional for migrants/refugees).
Discussion
The findings of this prospective pretest-posttest cross-national study will deepen our understanding of how a multilingual platform may promote access to mental healthcare services for LLP migrants and refugees. If successful, this intervention could be used to improve access to mental healthcare services, as well as HSCPs’ competencies in delivering such services, for any LLP migrants and refugees across Europe (and beyond).